International Public Health Commons^™

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …

A Mathematical Model Of The Spread Of Dengue Fever Incorporating Mobility, Kelly A. Reagan

Biology and Medicine Through Mathematics Conference

No abstract provided.

A Yellow Fever Epidemic: A New Global Health Emergency?, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

The worst yellow fever epidemic in Angola since 1986 is rapidly spreading, including the capital, Luanda. In Angola, the epidemic began in December 2015 and the laboratory-confirmed outbreak was reported to the World Health Organization (WHO) on January 21, 2016. Angola has had 2023 suspected cases and 258 deaths as of April 26, 2016. China, the Democratic Republic of Congo, and Kenya also have reported cases arising from infected travelers from Angola. Namibia and Zambia also share a long border with Angola, with considerable population movement between the countries. Similar to other recent epidemics, quick and effective action to stop …

Epidemiological Characteristics Of Clinically-Confirmed Cases Of Chikungunya In Teculutan, Guatemala, Annaly Aldana

Senior Honors Projects

As no vaccine currently exists for the Chikungunya virus (CHKV), mosquito control and efficient public health campaigns are crucial for the prevention of disease propagation. The purpose of this research project is to identify populations particularly at-risk for acquiring Chikungunya, and to explore the role that cultural attitudes may play in impacting mosquito-borne disease. Due to its geographical structure and climate, Guatemala is an ideal territory for the spread of emerging and re-emerging mosquito-borne diseases. This project was developed by collaborating with the public governmental health clinic in the municipal town of Teculután, in the department of Zacapa in Guatemala. …

A Retrospective And Prospective Analysis Of The West African Ebola Virus Disease Epidemic: Robust National Health Systems At The Foundation And An Empowered Who At The Apex, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic is a pivotal moment for the global health system. Just as the depth of the crisis ultimately spurred an unprecedented response, the failures of leadership demand innovative reforms. This analysis offers a template for these reforms, responding to the profound harms posed by fragile national health systems, delays in the international response, deficient resource mobilization, ill-defined responsibilities, and insufficient coordination. The scope of the reforms must address the failures evident in the Ebola response, as well as entrenched weaknesses that enabled the epidemic to reach its heights, transforming the existing inchoate, organically developed global health …

Antiretroviral Therapy Enrollment Characteristics And Outcomes Among Hiv-Infected Adolescents And Young Adults Compared With Older Adults — Seven African Countries, 2004–2013, Andrew F. Auld, Simon G. Agolory, Ray W. Shiraishi, Fred Wabwire-Mangen, Gideon Kwesigabo, Modest Mulenga, Sebastian Hachizovu, Emeka Asadu, Moise Zanga Tuho, Virginie Ettiegne-Traore, Francisco Mbofana, Velephi Okello, Charles Azih, Julie A. Denison, Sharon Tsui, Olivier Koole, Harrison Kamiru, Harriet Nuwagaba-Biribonwoha, Charity Alfredo, Kebba Jobarteh, Solomon Odafe, Dennis Onotu, Kunomboa A. Ekra, Joseph S. Kouakou, Peter Ehrenkranz, George Bicego, Kwasi Torpey, Ya Diul Mukadi, Eric Van Praag, Joris Menten, Timothy Mastro, Carol Dukes Hamilton, Mahesh Swaminathan, E. Kainne Dokubo, Andrew L. Baughman, Thomas Spira, Robert Colebunders, David R. Bangsberg, Richard Marlink, Aaron Zee, Jonathan Kaplan, Tedd V. Ellerbrock

OHSU-PSU School of Public Health Faculty Publications and Presentations

Although scale-up of antiretroviral therapy (ART) since 2005 has contributed to a decline of about 30% in the global annual number of human immunodeficiency (HIV)–related deaths and declines in global HIV incidence, estimated annual HIV-related deaths among adolescents have increased by about 50%, and estimated adolescent HIV incidence has been relatively stable. In 2012, an estimated 2,500 (40%) of all 6,300 daily new HIV infections occurred among persons aged 15–24 years. Difficulty enrolling adolescents and young adults in ART and high rates of loss to follow-up (LTFU) after ART initiation might be contributing to mortality and HIV incidence in this …

Is The United States Prepared For Ebola?, Lawrence O. Gostin, James G. Hodge Jr., Scott Burris

Georgetown Law Faculty Publications and Other Works

The West African Ebola epidemic is a humanitarian crisis and a threat to international security. It is not surprising that isolated cases have emerged in Europe and North America, but a large outbreak in the United States, with its advanced health system, is unlikely. Yet the handling of the first domestically diagnosed Ebola case in Dallas, Texas, raised concerns about national public health preparedness. What were the critical health system vulnerabilities revealed in Dallas, and how can the country respond more effectively to novel diseases in a globalized world?

Ebola: A Crisis In Global Health Leadership, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

At the core of the present Ebola crisis in West Africa is a lack of global health leadership. WHO should be the global health leader, following its constitutional charge, yet it is significantly under-resourced, having a direct effect on its rapid response capacity. The Organization's response to this crisis has been constantly behind, from low funding appeals to its delay in declaring this outbreak to be a Public Health Emergency of International Concern under the binding International Health Regulations (2005) (IHR). The IHR themselves have proven insufficient, as countries have failed to cooperate in building the public health capacities that …

Public Health In The Age Of Ebola In West Africa, Michael T. Osterholm, Kristine A. Moore, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The Ebola epidemic, with its fast-growing toll and real potential for spreading into much of Africa, including major cities, has the makings of a “Black Swan” event. Such events, using the term coined by Nassim Nicholas Taleb, are: 1) unpredictable, outside the realm of regular expectations; 2) have a major impact, and; 3) are rationalized after the fact as being explainable and predictable.

We have learned from this outbreak the potential for an infectious disease to be politically, economically, and socially destabilizing, and that what kills us may be very different from what frightens us or substantially affects our social …

The Ebola Epidemic: A Public Health Emergency Of International Concern, Lawrence O. Gostin, Daniel Lucey, Alexandra Phelan

Georgetown Law Faculty Publications and Other Works

On August 8, 2014, the World Health Organization (WHO) Director-General Margaret Chan declared the West Africa Ebola crises a “public health emergency of international concern,” triggering powers under the 2005 International Health Regulations (IHR).

The most affected West African states have attempted classic public health measures with varied success, including quarantine and isolation, social distancing, risk communication, and travel restrictions. These have involved a trade off between population health and human rights; sometimes to the disadvantage of both. At the same time, the countries’ health systems and human resources are fragile, impeding an effective response.

Beyond the public health and …

Virus Sharing, Genetic Sequencing, And Global Health Security, Lawrence O. Gostin, Alexandra Phelan, Michael A. Stoto, John D. Kraemer, K. Srinath Reddy

Georgetown Law Faculty Publications and Other Works

The WHO’s Pandemic Influenza Preparedness (PIP) Framework was a milestone global agreement designed to promote the international sharing of biological samples to develop vaccines, while that ensuring poorer countries would have access to those vaccines. Since the PIP Framework was negotiated, scientists have developed the capacity to use genetic sequencing data (GSD) to develop synthetic viruses rapidly for product development of life-saving technologies in a time-sensitive global emergency—threatening to unravel the Framework. Access to GSD may also have major implications for biosecurity, biosafety, and intellectual property (IP).

By rendering the physical transfer of viruses antiquated, GSD may also undermine the …

Using Quantitative Disease Dynamics As A Tool For Guiding Response To Avian Influenza In Poultry In The United States Of America, K. M. Pepin, E. Spackman, J. D. Brown, K. L. Pabilonia, Lindsey P. Garber, J. Todd Weaver, D. A. Kennedy, Kelly A. Patyk, K. P. Huyvaert, Ryan S. Miller, Alan B. Franklin, Kerri Pedersen, T. L. Bogich, P. Rohani, Susan A. Shriner, Colleen T. Webb, S. Riley

United States Department of Agriculture Wildlife Services: Staff Publications

Wild birds are the primary source of genetic diversity for influenza A viruses that eventually emerge in poultry and humans. Much progress has been made in the descriptive ecology of avian influenza viruses (AIVs), but contributions are less evident from quantitative studies (e.g., those including disease dynamic models). Transmission between host species, individuals and flocks has not been measured with sufficient accuracy to allow robust quantitative evaluation of alternate control protocols. We focused on the United States of America (USA) as a case study for determining the state of our quantitative knowledge of potential AIV emergence processes from wild hosts …

Implementing Incentive-Based Hiv Interventions In Zambia: The Compact Model, Sam Kalibala, Waimar Tun, Chabu Kangale, Jill Keesbury, Ray Handema, Mwaka Monze

HIV and AIDS

The Population Council received a cooperative agreement from USAID to implement the Community Mobilization for Preventive Action (COMPACT) project, to develop and determine the feasibility of “community compacts” as an innovative approach to prevent HIV in Zambian communities. The aim is to mobilize the communities through a capacity-building process that enables them to identify HIV prevention targets, develop interventions to achieve those targets, and measure the results. This study determined baseline levels of key indicators related to HIV, sexual behaviors, gender-based violence, alcohol abuse, and reproductive health. These baseline measures will be compared with midline and endline levels to assess …

Motivations For Entering Volunteer Service And Factors Affecting Productivity: A Mixed Method Survey Of Steps-Ovc Volunteer Hiv Caregivers In Zambia, Jessica Price, Tina Moyo, Stephanie Topp, Drosin Mulenga, Mardieh Dennis, Mathew Ngunga

HIV and AIDS

This study by the Population Council and the Zambia-Led Prevention Initiative was designed to examine the motivations of individuals volunteering as STEPS-OVC caregivers; to explore their experiences in service, including perceived barriers to carrying out their volunteer work and if, and how, their expectations for volunteering had been met or not; to assess individuals’ intent to continue caregiving; and to ascertain factors associated with volunteer productivity. Two main findings stand out from this study: that communitarian and religious helping values were virtually universal in the study population, and that a majority of the volunteers indicated economic and material interests and …

Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar

Poverty, Gender, and Youth

This program brief describes a Population Council initiative in three low-income areas of Ethiopia. Kalkidan (Amharic for “Promise”) is a three-year program designed to increase discussion and information-sharing on HIV and related topics between marital partners; to promote HIV prevention and health service utilization within marriage, including prevention of mother-to-child transmission (PMTCT) of HIV; and to build husbands’ support of their wives, as well as investment in their health and that of their children. Kalkidan recruits and trains community-based mentors to lead parallel discussion groups of husbands and wives, who periodically come together for joint sessions. The Population Council is …

Growing Up In Rural India: An Exploration Into The Lives Of Younger And Older Adolescents In Madhya Pradesh And Uttar Pradesh, K.G. Santhya, Shireen J. Jejeebhoy, Iram Saeed, Archana Sarkar

Poverty, Gender, and Youth

This technical report describes the situation of adolescents according to a baseline assessment conducted in selected villages in India. The objectives of the assessment were to explore the attitudes, practices, and behaviors of adolescent girls, their adolescent brothers and if married, their husbands, with regard to sexual and reproductive matters, including HIV; their perspectives on adolescent girls’ and boys’ vulnerability to HIV and ways in which it can be mitigated; and the perspectives of parents and other critical adults in the community on the vulnerability of adolescent girls and boys to HIV. Results will be used to: (1) enhance adolescent …

Refining The Global Spatial Limits Of Dengue Virus Transmission By Evidence-Based Consensus, Oliver J. Brady, Peter W. Gething, Samir Bhatt, Jane P. Messina, John S. Brownstein, Anne G. Hoen

Dartmouth Scholarship

Background: Dengue is a growing problem both in its geographical spread and in its intensity, and yet current global distribution remains highly uncertain. Challenges in diagnosis and diagnostic methods as well as highly variable national health systems mean no single data source can reliably estimate the distribution of this disease. As such, there is a lack of agreement on national dengue status among international health organisations. Here we bring together all available information on dengue occurrence using a novel approach to produce an evidence consensus map of the disease range that highlights nations with an uncertain dengue status.

Methods/Principle Findings: …

Nonclinical Development Needs And Regulatory Requirements For Multipurpose Prevention Technologies: A Primer, Joseph W. Romano, Martha Brady, Judy Manning

HIV and AIDS

This summary outlines key development elements that will be necessary for various configurations of multipurpose prevention products for the simultaneous prevention of HIV, sexually transmitted infections, and/or pregnancy.

Assessing And Improving Self-Reporting Of Male Circumcision In Zambia And Swaziland, Paul C. Hewett, Nicole Haberland, Barbara Mensch, Louis Apicella

HIV and AIDS

The Male Circumcision (MC) Partnership was established with the support of the Gates Foundation and PEPFAR to scale up MC services in Zambia, in collaboration with the Zambian government. The MC Partnership is a five-year project led by Population Services International (Society for Family Health, Zambia), in partnership with Jhpiego, Marie Stopes International (MSI), and the Population Council. The ultimate objective of this study is to provide researchers and program managers with evidence-based recommendations for the collection of self-reported data on MC status through an assessment of different methods to describe and explain MC. Specifically, the study assessed tools for …

The Experiences Of Men Engaged In Transactional Sex With Other Men In Urban Nigeria—A Size Estimation And Qualitative Study, Population Council

HIV and AIDS

Reports on a mixed-method research study to estimate the population size and understand the experiences of a sub-group of men who have sex with men presumed to be at particularly high risk of infection with HIV and other sexually transmitted infections: men who engage in transactional sex with other men.

Shaping The Operations Research Agenda For Antiretroviral-Based Prevention Products For Women: Gels And Rings, Martha Brady, C. Elizabeth Mcgrory

HIV and AIDS

This report summarizes discussions from a two-day international experts consultation meeting in 2012 on preparing for the successful introduction of women-centered antiretroviral-based HIV prevention methods. It examines the limits and expectations of operations research in antiretroviral health technologies.

Getting Real With Youth-Friendly Services In Africa: Report Of A Satellite Session At The Xix International Aids Conference, Population Council

HIV and AIDS

Overview of an AIDS 2013 satellite session which aimed to engage young people with and react to the study findings and in the light of the findings, discuss and share their perspectives, experiences and concerns about how responsive existing policies, programs and services are to the HIV prevention and impact mitigation needs of young Africans.

Prevalence And Correlates Of Hiv Infection In A Cohort Of Male Injection Drug Users In Delhi, Waimar Tun, Vartika Sharma, Mary Philip Sebastian, Ira Madan, Amita Yadav, Meredith Sheehy, Dean Lewis, Ibou Thior, Avina Sarna

HIV and AIDS

Baseline assessment of HIV infection among male injection drug users to understand the correlates of HIV infection and high risk injection practices and sexual behavior in Delhi, India.

Hiv/Aids In The Muslim-Majority Countries: Formula For Low Prevalence, Kaoru Yamaguchi

Political Science Theses and Capstones

The Muslim-majority countries long had been considered to be free of HIV/AIDS epidemic because of their strict religious and moral codes. However, the HIV prevalence rates are increasing in some Islamic states, and even more or so rapidly in a several cases that it is no longer valid to assume the Islamic religion protects its followers from the risks of contracting HIV. Contrary to the popular belief concerning the prevention of the HIV/AIDs epidemic, data collected from well-recognized international organizations such as the WHO and Freedom House indicate that democratization, strong government leadership, and wider and equal human rights for …

Household Survey To Evaluate The Zambia-Led Prevention Initiative: Baseline Report, Zambia-Led Prevention Initiative

HIV and AIDS

With an estimated HIV prevalence of 14.3 percent among men and women age 15–49, Zambia is one of the sub-Saharan African countries most affected by the HIV and AIDS pandemic. The Zambia-led Prevention Initiative Program (ZPI) was developed by a consortium led by FHI360, with the Population Council as the evaluation partner. This study determined baseline levels of key indicators related to HIV, gender-based violence, and reproductive health. Additionally, the baseline findings provide critical insights into key areas for interventions in Zambia and highlights variability in the populations across provinces and between males and females that provide valuable guidance for …

Positive Action For Hiv In Schools In Kenya, Francis Obare, Harriet Birungi, Monica Wanjiru, Sheila Bayley, John Kiunjuri, Mary Omondi, Rob Burnet, Bridget Deacon

Reproductive Health

The objective of this study was to test the feasibility of using comic books, role models, and edutainment to communicate HIV and AIDS messages to in-school young people in Kenya, with a view to improving their knowledge about the epidemic, enhancing communication about it, and promoting positive attitudes and behavior among them. The study was implemented by the Population Council in eight secondary schools in Nairobi, as part of the APHIA II Operations Research Project in collaboration with the AIDS Control Unit in the Ministry of Education, Well Told Story, and the National AIDS/STI Control Programme. The study found that …

Situation Assessment Of The Hiv Response Among Young People In Zambia, Sam Kalibala, Drosin Mulenga

HIV and AIDS

The main objective of this situational assessment is to compile and synthesize existing recent information on HIV and young people together with the current AIDS response for young people in Zambia—including programs, policies, and key partners—and to document gaps and challenges in the response. The assessment aims to further strengthen this response by all stakeholders including the Government of the Republic of Zambia, the UN, faith-based organizations, civil society organizations, donors, young people, and youth-led organizations. Recommendations include: amending and strengthening laws related to HIV programming for young people and involving them in design and implementation; offering health services, life …

Hiv Transmission Among Married Men And Women In Districts With High Out-Migration In India: Study Brief, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Umesh Chawla, Alka Narang

HIV and AIDS

This brief describes a study examining the links between male out-migration and HIV transmission among married men and women and other mechanisms by which HIV is transmitted within marital relationships in districts with high out-migration.

Facilitating Regulatory Approval Of Multipurpose Prevention Technologies For Sexual And Reproductive Health, Martha Brady

HIV and AIDS

This brief describes multipurpose prevention technologies (MPTs) that address women's sexual and reproductive health (SRH) needs, and how to go about facilitating regulatory approval of this technology. It outlines a strategic framework to examine current regulatory guidance, as well a product development pathway to bring MPTs to market.

What Regulatory Guidance Exists For Multipurpose Prevention Technologies (Mpts)? A Review Of Key Guidance Documents And Their Applicability To Mpts, Martha Brady, Heeyoung Park

HIV and AIDS

This brief reviews regulatory guidance documents and how they may apply to multi-purpose technologies (MPTs). It examines guidance documents from the Food and Drug Administration (FDA), the European Medicines Agency (EMA) and the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The brief concludes by anticipating increased interactions with US regulatory agencies in hopes of finding new regulatory pathways that address MPTs specifically.